Presence and persistence of Ebola or Marburg virus disease in patients and survivors

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Contact with blood and blood-stained body fluids remains the major risk for disease transmission.

Filovirus was reported in most types of body fluid, but not in every sample of otherwise confirmed cases. Only of 145 cases had detectable virus in blood after day 16 of illness. The latest positivity was day 29 of illness. There are conflicting results in two breastfeeding case studies, and other complex results for semen and in cases of pregnancy.

This review identified reviews which studied the presence of filoviruses in body fluids of infected people and survivors. The aim was to find primary data that suggested high likelihood of actively infection filovirus in human body fluids (viral RNA). Body fluids taken >16 days after onset were usually negative. In the six studies which used both assay methods, RT-PCR tests for filovirus gave positive results about four times more often than tissue culture.

After screening, 33 studies were eligible. The data included results from the same patients reported in different studies and had imprecise day-of-illness information. Results are best known for saliva and blood samples, and too few samples are known for strong conclusions to be made for breastmilk, vomit or sputum.  There were no semen samples before day 32 of illness. Presence of actively infectious virus in body fluids was reported in six different ways.

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